I have just declined an induction

[crazybutkind]

Just had a growth scan due to my first baby weighing 6lbs, this baby is weighing approx 6.7lbs and they wanted to induce me to which I said no.

I am 39+3 I have had 3 growth scans now, first 2 they weren't concerned this time they said they are concerned about babies weight.

My reasons for declining are due to the fact I haven't yet reached 40 weeks so not over due, my daughter was small, lol family babies have been small, I can still feel baby moving a lot and I don't want to be in a hospital with medical help on my own for potentially 3 days.
I said I would rather wait until next Monday (when I am overdue) then if they still feel the need to I will go ahead with induction.

After speaking to family I have been made to feel stupid and they have all said I should have agreed and I am being selfish and that I am potentially threatening the life of our baby.

I asked the doctor if it was what she would strongly advise and if there is any threat to myself or baby, she said no but would offer induction to women who are over due in any circumstance.

I phoned midwife when I got home to get another perspective really and she basically said I'm fine to decline until I am overdue and if nothing has happened by next week then go ahead with induction.

Basically I want someone to either be really blunt with me.

Have I been stupid?

Now o have come away and

I was scanned every week due to being on various medications (serious RTA at 17 weeks), and each time DD was measuring small. At 36 weeks they said that as she hadn't grown since the previous scan they were going to induce me. They advised me to go to the Asda, purchase some tiny baby clothes and head straight back, which I did. I was induced that evening, baby was born two hours later. I had a full team in the room waiting for my tiny baby...who turned out to be 7lb. So, growth scans can be very misleading.

I would go for the induction personally, in my experience they are not offered unless there is deemed to be clinical need and if you refuse it and have a bad outcome you would spend a life time wondering ‘what if’. I was induced with both my babies and although both were estimated to be 7lbs the inductions were initiated because the rate of growth had slowed and was indicative of potential failure of the placenta. So not the weight per se but the rate of growth between each scan. It wasn’t what I wanted in an ideal world, but I knew that I couldn’t live with the guilt if I went against medical advice and something happened to my baby.

They have mentioned nothing about the growth just the weight. I checked my notes from my last 3 scans and each time baby had grown and is moving up the growth chart. That's what I wanted to avoid the "what ifs" my head is not clear and I don't feel I was given enough information as to reasons why

I only know one woman who declined induction (a midwife incidentally) her baby was still born.

You did say to be blunt.

I agree with taking the medical advice. And err on the safe side.

OP - reading some other comments makes me realise there's perspectives I hadn't looked at.

Is she growing on her curve? All my scans had a print out with where she was plotting so you could see if she was consistently measuring at 50th centile over a course of weeks - usually they measured head, tummy and femur I think. Can you look back over the last few scans to see if the markers are always in the same place - or if for example she was 75th for tummy two weeks ago and now is 50th?

There is often q chart on the bottom or back of the print out too. (I practically memorised my notes but I was a very anxious pregnant lady)

I would personally take the induction if it's being recommended by them..I had two with both of my children and they were ok..babies born healthy and alive and that's all what matters imo..
If I was to wait until overdue and anything would happen to the baby I don't know how will I forgive myself..over couple of days it's not worth it..but that's just me you need to make your own decision based on what you feel is right..

I would want to speak to the doctor in more detail about exactly why they are recommending induction, and look at the NICE guidelines and a website called evidence based birth. Inductions, especially before your body is ready are not fun and can often lead to more intervention. It might be reasonable for you to be induced now, but from what you've said your medical team haven't been that convincing about it.

FYI, I know a few people who have declined induction when overdue (so different reason) with no problems. Personally I find anecdotal stories about this sort of thing not very helpful and prefer to look at research evidence.

Is the measurements based on tummy size because the sonographer struggled with getting a tummy measurement today due to how she was sat

All the measurements are combined to produce an estimated weight. The individual measurements are as important as the weight though - have any of them dropped centiles?

Have they offered induction JUST because the baby is small or because the baby’s growth is reducing? A baby on the 10th centile that’s always been small is not concerning, a baby that was on the 50th centile and has reduced to the 10th centile is a completely different matter.

@zaffa NICE guidelines actually say if the only indication is a large baby then induction should NOT be recommended. It should only be recommended if there are other concerns.

I’m not going to give my opinion as I agree with pp who said anecdotal evidence isn’t helpful. Have you looked up AIMS? They are a charity promoting better births, and have a lot of info on induction on their website. I’ve just finished reading their book on induction (all the research summarised that Drs use to make recommendations) and have found it really helpful to prepare for my own consultant appointments. They also have a helpline you can call to talk things through. Good luck xx

I declined an induction for my second, and opted for a c section at 41 weeks. Induction with first was long and traumatic and ended in c section. Thankfully all was well.

I’d be a bit concerned that you don’t seem 100% clear on why they’ve offered induction, and therefore it’s dubious whether you declining it was an informed decision.

It would be very unusual for a baby to not grow/put on weight between scans, but if the rate of growth has slowed down, that would be concerning. During the scan they will have monitored the blood flow in the umbilical cord. These measures indicate whether the placenta is still working well. If any of these markers were concerning then they would have offered induction also.

I think it may be worth you talking to a midwife or doctor tomorrow to get all the information on why induction was suggested. Suggesting inducing a baby on the 50th centile before 40 weeks would be very unusual.

@tmc14 I think combined with previous concerns that baby wasn't moving and the expected weight being on the 99th percentile along with an even higher tummy measurement is why they recommended my induction. In the end the measurements were wrong but I appreciate erring on the side of caution - I can look back and be dissatisfied with the complications that arose (I also am the one in 200 who had a post Dural puncture following the epidural) but I don't know what would have happened if I hadn't opted for it. I do think it's important to have all the info to hand but I deferred to the doctors when they had a recommendation as they delivered babies every day - I'd never done it so I felt they knew better.

Not everyone will agree and that's as expected - that's just my personal view and advice.

@zaffa apologies, from your first post it seemed the only issue was with the overall predicted weight. If there were concerns about movement &/or specific measurements that’s a different matter, and is then individual specific, which is as the care should be.

I think deferring to Drs is absolutely fine, but I also know that often certain tick boxes (which are needed when talking about whole populations) aren’t always appropriate for an individual. My own example is that I’m over 40, so they want to induce early due to increased risk of stillbirth. BUT, that data is of relatively low quality (2c, the lowest they make recommendations on), and the fact I’ve given birth with no issues before lowers my personal risk by quite a bit. Plus all my family have longer gestation periods. So it’s a detailed conversation with my midwife/consultant to make the best choice for my specific circumstances. I think if I were @crazybutkind I would be wanting more detailed conversations about her specific situation so that the best decision can be made for her.

I think you're fine op. Give it another week if no probs. Good luck x

I rang for further info when I got home and the midwife I spoke to said it's absolutely fine to decline given I'm not actually over due and baby is moving fine. The ultra sound I had prior to speaking to the doctor was fine he checked the cord, the fluid, the blood flow, the heartbeat, the thigh bones and head measurements and as we talked while he did the ultrasound I mentioned my first was only 6lb and he said "well this baby is over 6lbs".

You sound uncertain OP. I think direct your uncertainty towards getting further information from your medical team. Experience from others is useful, but don't let that falsely reassure you against seeking expert advice. It sounds like your medical team were concerned enough to recommend an induction. I would think about the worst case outcomes of each scenario in your decision. All the best with your decision and your baby :)

I am a little concerned now. I was reading all the comments and someone mentioned baby going from 50th centile to 10th so I checked my book again....

Don't worry unduly OP - they didn't think it was serious enough to book you in for an induction today so nothing you have accepted or declined makes an immediate difference. It does look like your baby has dropped on the centile lines so it's probably worth a conversation with your consultant - but I'm not a doctor (and have just the one baby) so the only advice I can give is to go back and ask more of questions / for further clarity.

I think you need more information. Is there a specific concern about the baby or is it just a general recommendation based on the overall picture?

Personally if it was the former and there was an issue with placental blood flow/growth velocity that suggested the placenta was failing then I’d go for induction. Otherwise I’d be tempted to wait but I’d ask about the possibility of having regular CTG monitoring in the meantime.

If it's that concerning why not csection? Induction is unlikely to work if baby isn't ready to come out and can be quite traumatic. If she seems well, stick to your guns.

@tmc / I think in my case I'm also overweight and over 35 so I had a number of factors that linked together made them err on the side of caution.

Directly afterwards I wished I had declined because it felt like I had ended up in w situation that required intervention and I may not have needed that if I had just left well alone. After a while I realised that I couldn't have predicted WhT would have happened if I'd gone into labour spontaneously, and at the end of it I had a healthy baby so just to focus on that. Also whilst it was hard to have a section I was terrified of tearing so I was happy with that part!

I think being informed is the most important part - I was a bit passive with just doing as I was told and that's fine if you had my mindset but that doesn't work for a lot of people and as you say they need to make the right decisions for their individual case.